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465 Mass. 102 - Appellant Medina Brief - Mass Cases

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•<br />

• TABLE OF CONTENTS<br />

TABLE OF AUTHORIT ................................ J.J.<br />

ISSUES PRESENTED ..................................... 1<br />

• STATEMENT OF THE CASE ................................ 1<br />

•<br />

•<br />

•<br />

PRIOR PROCEEDINGS AND STATEMENT OF FACTS ............. 3<br />

STANDARD OF REVIEW ................................... 7<br />

ARGUMENT ....... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8<br />

I. DR. HOCHBERG'S DUTY TO WARN HIS PATIENT AGAINST<br />

DRIVING WHILE SUBJECT TO SEIZURES EXTENDS TO THE<br />

DRIVING PUBLIC ....................................... 8<br />

A. The Physician's Duty ses From: (i) s Creation<br />

Of A sk And (iil The Physician-Patient ationship<br />

.. . .. .. . .. .. .. .. .. .. .. .. .. .. .. .. . .. .. ".. " .. .. .. .. .. .. .. ., .. .. .. .. .. .. .. .. .. .. .. .. ., .. .. .. .. .. .. .. .. a<br />

i.. Risk Creation""""." ............ " ... " . It " " " " " ......... ., .. " .... " B<br />

ii. The , Physician-Patient Relationship<br />

........... 11<br />

B. Dr. Hochberg's Duty To Warn Extends The Driving<br />

Public Under Ordi Principles Negligence ..... 15<br />

II. THE RECOGNITION OF A SPECIAL RELATIONSHIP WITH<br />

POTENTIAL THIRD-PARTY VICTIMS IS CONSISTENT WITH<br />

MASSACHUSETTS COMMON LAW AND STATUTORY LAW .......... 17<br />

III. PUBLIC ICY SUPPORTS THE IMPOSITION A DUTY<br />

TO WARN A PATIENT AGAINST DRIVING WHILE SUBJECT TO<br />

ZURES " .. It .. " " ...... '" .. " .. " " " " .... " ............ "" .. " " " " " .. " .............. " " 23<br />

IV. SUMMARY JUDGMENT WAS INAPPROPRIATE BECAUSE THERE<br />

ARE DISPUTED ISSUES OF MATERIAL FACT ................ 28<br />

CONCLUSION .......................................... 32<br />

CERTIFICATION ....................................... 33


•<br />

•<br />

•<br />

•<br />

•<br />

TABLE OF AUTHORITIES<br />

CASES<br />

Adamian v. , Inc.<br />

353 Ma s s. 4 98 (1968) .............................. 18<br />

Allstate Insurance Company v. Dalyrymple<br />

883 F.Supp. 963 (1995) ............................ 30<br />

Brune v. Bel ff<br />

354 <strong>Mass</strong>. <strong>102</strong> (1968) .......................... 11, 12<br />

Carey v. New England Organ Bank<br />

446 <strong>Mass</strong>. 270 (2006) ............................... 7<br />

Carr v. Howard<br />

5 <strong>Mass</strong>. L. Rep. 63 (Norfolk Super. .1996) ... 19, 21<br />

Cassesso v. Comm'r of Carr.<br />

390 <strong>Mass</strong>. 419, 422 (1983) ......................... 29<br />

Coombes v. Florio<br />

450 <strong>Mass</strong>. 182 (2007) .......................... pass.un<br />

• Duvall v. Goldin<br />

139 Mich. App. 342 (1985) ................. 26, 27, 29<br />

•<br />

•<br />

•<br />

Freese v. Lemmon<br />

210 N.W.2d 576 (Iowa 1973) ........................ 31<br />

v. Tips<br />

651 S.W. 2d 364 (Tex. App. Ct. 1983) .......... 24, 28<br />

v. Allstate Ins. Co.<br />

883 F.Supp.963 (0.Oel.1995) ................... 27, 31<br />

Hub Associates, Inc. v.<br />

357 Ma s s. 4 4 9 (1970) ............................... 7<br />

Irwin v. Town of Ware<br />

3 92 Ma s s. 74 5 (1984) .............................. 20<br />

Joy v. Eastern Maine Med. Ctr.<br />

529 A.2d 1364 (Me.19B7) ........................... 27<br />

• Lev v. Beverly Enterprises-<strong>Mass</strong>achusetts, Inc.<br />

4 57 Ma s s. 23 4 ( 2 0 10) ............................... 7<br />

•<br />

ii


•<br />

•<br />

•<br />

Luoni v. Thomas Berube<br />

431 Ma s s. 72 9 ( 2 000) .............................. 18<br />

Maffei v. Roman Catholic shop of Boston<br />

4 4 9 Ma s s. 2 3 5 ( 2 007) ............................... 7<br />

McGuiggan v. New England Tel. & Tel. Co.<br />

398 Ma s s. 152 (1986) .............................. 18<br />

McKenzie v. Hawai'i Permanente Med. Group, Inc.<br />

98 Haw. 296 (2002) ................................ 27<br />

• <strong>Medina</strong> v. llemer<br />

2005 WL 3 7226 (Suffolk . Ct. 2005) .... . passim<br />

•<br />

•<br />

•<br />

•<br />

•<br />

Mullins v. Manor ColI , 389 <strong>Mass</strong>. 47 (1983)<br />

389 <strong>Mass</strong>. 47 (1983) ............................... 18<br />

Myers v. Queensberry<br />

144 Cal. App. 3d 888 (1983) ................... 26, 30<br />

Pederson v. Time, Inc.<br />

404 s. 14, 16-17 (1989) ....................... 7, 29<br />

Poskus v. Lombardo's of Randolph<br />

4 2 3 Ma s s. 637 (1996 ) .............................. 19<br />

Riggs v. stie<br />

342 <strong>Mass</strong>. 402 (1961) .............................. 12<br />

Small v. Howard<br />

128 <strong>Mass</strong>. 131 (1880) .............................. 12<br />

Schuster v. Altenberg<br />

144 Wis.2d 223 (1988) ............................. 28<br />

Stepakoff v. Kantar<br />

393 <strong>Mass</strong>. 836 (1985) .............................. 11<br />

Taylor v. Smith<br />

892 So.2d 887, 893-94 (Alabama Sup.Ct. 1994) ...... 27<br />

Welke v. Kuzilla<br />

144 Mich.App. 245 (1985) .......................... 26<br />

• Wharton Transport Corp. v. Bridges<br />

606 SW2d 521 (1980, Tenn) ......................... 16<br />

iii


•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

•<br />

Wilschinsky v. <strong>Medina</strong><br />

108 N.M. 511, 515 (1989) .......................... 27<br />

Zavalas v. State Dep't of Carr.<br />

124 Ore.App. 166 (1993) ........................... 28<br />

STATUTES<br />

5 4 0 CMR § 2 4 • 0 5 • • • • • • • . . • • • • • • • . • • • • . . • . • • • • . • • • • . • • 2 5<br />

M.G.L.A. 112 § 129A ............................. 21, 22<br />

SECONDARY SOURCES<br />

51 MAPRAC § 2. 2 .................................... 12<br />

Prosser, William L.<br />

Handbook of The Law of Torts (4th ed. 1971) ....... 14<br />

iv


ISSUES PRESENTED<br />

i. Does a physician have a special relationship,<br />

either with s patient or with the eseeable<br />

class of victims, that imposes a duty upon the<br />

physician to advise a patient who is subject to<br />

seizures not to drive a motor vehicle?<br />

ii. Alternatively, a physician's indication to<br />

his s zure-prone patient that driving is<br />

permitt cons tute a creation of risk?<br />

iii. Does the sk of rm created by this a rmat<br />

act extend to third-party ctims under the<br />

Coombes lding?<br />

iv. Is there a dispute of material s, such that<br />

summary judgment for Dr. Hochberg was improper?<br />

STATEMENT OF THE CASE<br />

This civil action was init lly entered in the<br />

Superior Court Department of the T al Court for<br />

Suffolk County. The action was commenced by<br />

aintiff-<strong>Appellant</strong>, Richard <strong>Medina</strong> ("<strong>Medina</strong>"),<br />

against Francine Pillemer, As Executrix of The Estate<br />

of Robert D. Riskind ("Riskind") on January 23, 2004.<br />

Riskind was suffering from a non-curable<br />

malignant in tumor which made him subject to<br />

zures. He was treating for this condition with a<br />

1


neurologist, H. Hochberg, M.D. (Dr. Hochberg).<br />

Dr. Hochberg was aware that Riskind was regularly<br />

driving a motor vehicle and iled to warn, advise, or<br />

instruct Riskind not to drive, despite the fact that<br />

Riskind was experiencing severe neurological symptoms.<br />

Instead, he affirmatively indicated to Riskind in<br />

writing that driving was permitted.<br />

On December 10, 2001, Riskind had a zure while<br />

driving a motor vehicle, which caus him to serious<br />

ure t Plaintiff-<strong>Appellant</strong>, <strong>Medina</strong>. On April 25,<br />

2005, the Superior Court (Gants, J.) allowed <strong>Medina</strong>'s<br />

motion to add Dr. Hochberg as a party defendant, on<br />

the grounds that breached his duty to the driving<br />

public.<br />

However, on July 25, 2011, the Superior Court<br />

(Hogan, J.) issued a decision allowing summary<br />

judgment for Dr. Hochberg, contradicting 2005<br />

Decision. The court concluded that this commonwealth<br />

does not recognize a physician's duty to a third party<br />

to warn his patient against driving while subject to<br />

seizures.<br />

2


•<br />

6. September 19, 2001, Dr. Hochberg's notes<br />

• indi Riskind continued to have two to three<br />

seizures a y. See App: A-43.<br />

7. On 17, 2001, Dr. Hochberg wrote a letter<br />

• to Riskind, stating: "You are now able to ... drive<br />

a car".<br />

• 8 . On December 10, 2001, Riskind was driving a car<br />

on Washington reet Newton, <strong>Mass</strong>achusetts, when he<br />

suffered a seizure, by his neurological<br />

• condition. As a re having a seizure while<br />

driving, the automobi<br />

by Riskind veered<br />

from the highway, st<br />

Plaintiff-<strong>Appellant</strong><br />

• <strong>Medina</strong>, a pedestrian who was walking to the trunk of<br />

•<br />

•<br />

•<br />

his car. <strong>Medina</strong> suf<br />

of the motor vehicle<br />

334, A-33S.<br />

severe injuries as a result<br />

9. On January 23, 2004, <strong>Medina</strong> 1 s t k<br />

Superior Court against Francine Pillemer, As Executrix<br />

of The Estate of Riskind. The Complaint all<br />

said decedent, Riskind, was negligent operat s<br />

motor vehicle on December 10, 2001, which resulted<br />

said vehicle to swerve off the highway and strike and<br />

• ure the plaintiff, <strong>Medina</strong>, a pedestrian who was<br />

•<br />

wal to the trunk of his car. A certified copy of<br />

4<br />


•<br />

the Superior docket entries and a copy of<br />

• Complaint are at hereto. See App: A-1, A-9.<br />

10. On January 8, 2005, the plaintiff obtained<br />

complete cal from Dr. Hochberg. The<br />

• plainti promptly had the medical records<br />

reviewed by a expert, John M. Friedberg,<br />

• M.D. ("Dr. ), to determine whether there was<br />

any the standard of care by Dr.<br />

Hochberg to advise, warn or instruct<br />

• Riskind not to e a motor vehicle. Dr.<br />

•<br />

•<br />

•<br />

•<br />

established "the seizure of December 10, 2001,<br />

was reas seeable u and concluded as follows:<br />

"Dr. rg, a professor of neurology who<br />

knows and knew his patient Dr.<br />

Riskind, have expressly and repeatedly<br />

, instructed, and warned his<br />

no uncertain terms never to operate a<br />

Dr. Hochberg's failure to do so,<br />

cit encouragement to his patient<br />

to continue , is incomprehensible and a<br />

signi rture from the standard of<br />

medical part of a neurologist. It<br />

clearly ow the standard of care of the<br />

ave neurologist and was a major<br />

contribut in the accident of December<br />

10, 2001, severely injured your client,<br />

Richard <strong>Medina</strong>./l See App: A-54.<br />

11. On March 16, 2005, <strong>Medina</strong> filed a motion with the<br />

Superior Court to Dr. Hochberg as a party<br />

• defendant and to Ie his First Amended Complaint. See<br />

App: A-13.<br />

•<br />

5


•<br />

•<br />

12. On April 25, 2005, the Superior Court (J. Gants)<br />

issued a decision (hereinafter "the 2005 Gants<br />

decision"), allowing the Plaintiff's motion to add Dr.<br />

Hochberg as a party defendant on the grounds that Dr.<br />

• Hochberg had a duty to advise his patient against<br />

driving while subject to seizures. See App: A-57.<br />

• 13. On July 25, 2011, the Superior Court (J. Hogan)<br />

contradicted the 2005 Gants decision and allowed<br />

•<br />

•<br />

•<br />

summary judgment for Dr. Hochberg. The court ruled<br />

that a physician does not owe a duty to the driving<br />

public to warn his patient against driving as a iesult<br />

of a seizure disorder. Judgment was entered on August<br />

5, 2011. See App: A-336, 383, 402.<br />

14. On August 31, 2011, <strong>Medina</strong> filed a notice of<br />

appeal. See App: A-6. On February 8, 2012, the case<br />

was docketed in the Appeals Court. SeeApp: A-404.<br />

15. On February 15, 2012, <strong>Medina</strong> filed an Application<br />

• for Direct Appellate Review with the Supreme Judicial<br />

•<br />

Court. On March 27, 2012, the Court allowed <strong>Medina</strong>'s<br />

application.<br />

16. On April 6, 2012, this case was entered on the<br />

docket of the Supreme Judicial Court. On April 11,<br />

2012, the Court allowed <strong>Medina</strong>'s Motion to file this<br />

amended brief.<br />

6


STANDARD OF REVIEW<br />

The standard of review of a grant of summary<br />

judgment is whether, viewing the evidence in the light<br />

most favorable to the nonmoving party, all material<br />

facts have been established and the moving party is<br />

entitled to judgment as a matter of law. Lev v.<br />

Beverly Enterprises-<strong>Mass</strong>achusetts, Inc., 457 <strong>Mass</strong>.<br />

234, 237 (2010). In order to be entitled to summary<br />

judgment, the moving party must affirmatively show<br />

that there is no real issue of fact. Hub Associates,<br />

Inc . .'Y..:.. Goode, 357 <strong>Mass</strong>. 449, 258 N.E.2d 733, (1970).<br />

See Iso Pederson .'Y..:.. Time, Inc., 404 <strong>Mass</strong>. 14, 16-17<br />

(1989) (the moving party has the burden of<br />

establishing that no material facts are in dispute) .<br />

On review of a motion judge's order granting<br />

summary judgment, the Appellate Court reviews the<br />

motion judge's legal conclusions de novo. Maffei .'Y..:..<br />

Roman Catholic Archbishop of Boston, 449 <strong>Mass</strong>. 235<br />

(2007). When the Supreme Judicial Court reviews a<br />

summary judgment motion, it makes all permissible<br />

inferences favorable to the nonmoving party and<br />

resolves any disputes or conflicts in summary judgment<br />

materials in their favor. Carey .'Y..:.. New England Organ<br />

Bank, 446 <strong>Mass</strong>. 270, 273 (2006).<br />

7


against driving due to the risk of losing<br />

consciousness. In fact, the physician in Coombes<br />

affirmatively indicated to s patient that he could<br />

safely resume driving. at 185. As a result of the<br />

side effe s from the medication, the patient lost<br />

consciousness while driving, his automobile left the<br />

road, and he injured a third party who was standing on<br />

the sidewalk. Id. Because was the physician's "own<br />

act of prescribing medication that created the<br />

foreseeable sk of an accident,H there was no need to<br />

impose a "special relationship" duty to hold the<br />

physician liable to the third party. rd. at 194. The<br />

Court held that a duty arises out of the physi an's<br />

creation of a driving risk.<br />

Here there was an affirmative action taken by Dr.<br />

Hochberg that created the risk of a motor vehi<br />

accident. This occurred when he indicated to his<br />

patient that driving was permitted. The evidence<br />

establishes that just months prior to the incident Dr.<br />

Hochberg was aware his patient was suffering from a<br />

degenerative health condition accompanied by seizures.<br />

On September 5, 2001, the physician's notes indicate<br />

Riskind's neurological condition was so severe that he<br />

"began to substitute the word 'chicken' for virtually<br />

9


all words." See AEP: A-41. As a result, Dr. Hochberg<br />

increased Riskind's Decadron, a medication to shrink<br />

the surrounding swelling, and put him on a<br />

chemotherapeutic agent usually reserved for leukemia.<br />

Id. On September 19, 2001, Dr. Hochberg's notes<br />

indicate that Riskind continued to have two to three<br />

seizures a day. See AEE: A-43. Dr. Hochberg was in a<br />

unique position to fully understand Riskind's health<br />

condition and adequately warn him to prevent a motor<br />

vehicle accident. However, instead of warning Riskind<br />

against driving he actually indicated in writing that<br />

Riskind was able to drive the very next month, on<br />

October 17, 2001. See AEE. A-44. Eight weeks after<br />

receiving this written indication from Dr. Hochberg,<br />

Riskind had a seizure while driving as a result of his<br />

health condition. Just like the patient in Coombes,<br />

his car left the road and hit <strong>Medina</strong>, who was walking<br />

to the trunk of his car. According to the medical<br />

expert, "Dr. Hochberg's failure to [warn Riskind],<br />

indeed his implicit encouragement to his patient to<br />

continue driving, is incomprehensible and a<br />

significant departure from the standard of medical<br />

care on the part of a neurologist." See AEP: A-54.<br />

10


executrix of his estate had brought a claim for<br />

negligence against Dr. Hochberg, sed on the<br />

allegation he breached the standard of care by<br />

failing to advise the patient not to drive. In that<br />

scenario, "there would be no question that the<br />

executrix had stated a valid claim aga tOr.<br />

Hochberg." See App: A-64. This Court should similarly<br />

hold that Dr. Hochberg owed his patient a duty to warn<br />

that arises out of their special relationship.<br />

In the 2011 decision to allow summary judgment<br />

Dr. Hochberg, the Superior Court sapprehended<br />

the applicable law and stated that a physician's duty<br />

to warn cannot arise out of "the simple act of<br />

accepting Riskind as a patient". See App: A-39B. This<br />

conclusion was ly incorrect for two reasons.<br />

First, a physician's act of accepting and treating a<br />

patient is in enough to impose a duty to act<br />

affirmatively to prevent harm to his patient. This<br />

flows logically from the physician's andard of care<br />

as explained through the common law above. Second, it<br />

is not merely the "simple act" of treating that <strong>Medina</strong><br />

a forms the basis Dr. Hochberg's duty. The<br />

duty in this case arose because (1) the physician knew<br />

his patient was driving with a disorder that causes<br />

13


already owed a duty of care to Riskind, "he could not<br />

avoid that duty by iling to offer advice - a<br />

doctor's error of omission may be as or more serious<br />

than his error of commission." Id. This is especially<br />

evident where, as here, the physician was aware that<br />

his patient was driving. Thus, whether he failed to<br />

warn his patient or affirmatively indicated that<br />

driving was permitted is of no consequence. In either<br />

case, such act or omission fell below the standard of<br />

care of a neurologist.<br />

B. Dr. Hochberg's Duty To Warn His Patient<br />

Extends To The Driving Public Under Ordinary<br />

Principles of Negligence.<br />

The risk created by the physician's af rmative<br />

act and by his failure to warn his patient extends to<br />

<strong>Medina</strong> as a foreseeable third-party victim. In<br />

Coombes, the Supreme Judicial Court extended a<br />

physician's duty to third parties under principles of<br />

ordinary negligence. 450 <strong>Mass</strong>. at 190. The court held<br />

"A physi an owes a duty of reasonable care to<br />

everyone foreseeably put at risk by his failure to<br />

warn of the side effects of his treatment of a<br />

patient". Id. In other words, because a physician has<br />

a duty of reasonable care in his treatment of a<br />

patient (an affirmative act), this duty extends to<br />

15


public illustrates the eeability harm to this<br />

class of potential victims. Even The Supreme Judicial<br />

Court recognized the fore lity of this harm in<br />

Coombes, noting that warnings nserve to protect the<br />

public from the very harm that creates the parallel<br />

duty to the patient." 450 <strong>Mass</strong>. at 191. Furthermore,<br />

the that Dr. Hochberg knew his ient was still<br />

driving which is evident in the October 17, 2001<br />

letter to Riskind - also trates the<br />

fore lity of harm that would result from a motor<br />

vehicle accident. See App: A-44. Therefore, Dr.<br />

Hochberg's duty to Riskind extends to all seeable<br />

vict ,including the Plaintiff-<strong>Appellant</strong>.<br />

II. THE RECOGNITION OF A SPECIAL RELATIONSHIP WITH<br />

POTENTIAL THIRD-PARTY VICTIMS IS CONSISTENT WITH<br />

MASSACHUSETTS COMMON LAW AND STATUTORY LAW.<br />

n<strong>Mass</strong>achusetts law . is s as to whether<br />

a physician has a special ionship, either with<br />

his pat or with the foreseeable class of victims,<br />

imposes a duty upon the physician to advise- a<br />

patient who is subject to zures not to drive a<br />

motor vehicle." <strong>Medina</strong> v. Pillemer, 2005 WL 3627226<br />

(<strong>Mass</strong>.Super. 2005). However, the recognition of s<br />

duty is ly consistent with the common law of<br />

<strong>Mass</strong>achusetts. A review of <strong>Mass</strong>achusetts common law<br />

17


(as undertaken in the 2005 Gants Decision) reveals<br />

four broad categories of cases in which a special<br />

relationship triggers a duty to protect a potential<br />

victim from harm committed by a third person:<br />

i. When an individual commits an affirmative<br />

act that creates or increases the risk that the third<br />

person will harm a potential class victims, the<br />

individual owes a duty to the potential victim class<br />

to act reasonably in performing that affirmative act.<br />

See, for example, Adamian v. Three Sons, Inc., 353<br />

<strong>Mass</strong>. 498 (1968) (e.g. tavern owner's duty to stop<br />

serving customer when he reasonably should know the<br />

customer is intoxicated); and McGuiggan v. New England<br />

Tel. & Tel. 398 <strong>Mass</strong>. 152 (1986) (social host<br />

owes a duty to potent 1 class of victims to stop<br />

serving his guest when he reasonably should know the<br />

guest is intoxicated.)<br />

ii. When there is a special relationship between<br />

the defendant and an identifiable limited class of<br />

persons that includes the plaintiff, the defendant may<br />

owe a duty to the plaintiff to protect him from the<br />

dangerous or unlawful acts of a third person. Luoni v.<br />

Thomas Berube, 431 <strong>Mass</strong>. 729 (2000). See also Mullins<br />

v. Pine Manor College, 389 <strong>Mass</strong>. 47 (1983) (a college<br />

18


owes a duty to its students to take reasonable steps<br />

to protect them from harm from foreseeable criminal<br />

acts. See also Poskus v. Lombardo's of Randolph, 423<br />

<strong>Mass</strong>. 637 (1996) (landlord or property owner may be<br />

liable for failing to prevent reasonably foreseeable<br />

criminal acts).<br />

iii. When there is a special relationship between<br />

the defendant and the third person who commits the<br />

harmful conduct, the defendant may have a duty to a<br />

foreseeable class of victims to control the third<br />

person's conduct or to provide reasonable warning<br />

the third person's conduct. See, for example, Carr v.<br />

Howard, 5 <strong>Mass</strong>. L. Rep. 63, *15 (Norfolk Super.<br />

Ct .1996) (a psychiat st and a psychiatric hospital<br />

that have custody over patients who are dangerous to<br />

themselves and others owe a common law duty to<br />

"members of the public to take reasonable precautions<br />

to control their patients H ).<br />

iv. In certain circumstances, public employees<br />

have a special relationship with the general public<br />

and therefore owe a duty to them when the foreseeable<br />

threat posed by inaction is potentially "calamitous,H<br />

and statutes or ordinances reflect a legislative<br />

intent to protect the general public from the threat.<br />

19


"When there is a special relationship between the<br />

defendant and the third person who commits the<br />

harmful conduct, the defendant may have a duty to<br />

a foreseeable class of victims to control the<br />

third person's conduct or to provide reasonable<br />

warning of the third son's conduct." Citing<br />

Carr v. Howard, 5 <strong>Mass</strong>. L. Rep. 63, *15 (Norfolk<br />

Super. Ct. 1996).<br />

This is the rationale, for instance, behind imposing a<br />

duty on psychologists to warn potent victims that<br />

their ients intend to harm them. Under<br />

<strong>Mass</strong>achusetts G.eneral Laws, a psychologist has a duty<br />

to take reasonable precautions to prevent harm to a<br />

"reasonably identifiable victim". See M.G.L.A. 1 §<br />

To comply with this duty, the statute allows a<br />

psychologist to breach the psychotherapist privilege<br />

and make a limited disclosure to a potential victim<br />

who may be seriously injured by the patient. See Id.<br />

The psychologist has a duty to prevent harm to a<br />

limited class of potent 1 victims - those who he<br />

reasonably believes are threatened by his patient's<br />

conduct. Similarly, as discussed infra, the Coombes<br />

holding bridges the gap between a physician and the<br />

driving public, requiring the physician to warn his<br />

pat against driving in order to prevent harm to<br />

potenti victims. When considered together,<br />

2.1


<strong>Mass</strong>achus s common law and statutory law justify the<br />

imposition of this duty.<br />

This case presents a textbook example of when a<br />

physician breaches his duty to non-patient victims.<br />

Dr. Hochberg had a special ionship with his<br />

ient, Riskind, and with the driving puolic - a<br />

limited ss of potential victims that included<br />

<strong>Medina</strong>. He was aware that Riskind was suffering from a<br />

degenerative health condition accompanied by seizures.<br />

On September 5, 2001, Riskind's neurological condition<br />

was so severe that he "began to substitute the word<br />

'chicken' for virtually all words." App: A-41. On<br />

September 19, 2001, . Hochberg's notes indicate that<br />

Riskind continued to have two to three zures a day.<br />

See App: A-43. Instead warning his patient not to<br />

drive, actually indicated in writing that Riskind<br />

was to drive the next month, on October 17, 2001.<br />

See App. A-44. <strong>Mass</strong>achus s General Law 112 §129A<br />

allows a psychologist to warn the potential victim (a<br />

non-patient) of the threat harm because that is the<br />

most reasonable way to prevent harm to the foreseeable<br />

victim. Here, the most reasonable step for<br />

Hochberg to prevent harm to skind was merely warning<br />

his own patient not to drive. Such advice is less<br />

22


subject to seizures is not as restrictive as the<br />

Defendant-Appellee suggests. Moreover, under the<br />

proposed duty, physicians would 'only be expected to<br />

advise their patients against driving when the threat<br />

of injury in a motor vehicle accident is a real,<br />

foreseeable risk. Where a risk is not apparent in the<br />

first place, the physician will obviously not be<br />

required to warn his patient against driving. Medical<br />

expert testimony in the present case suggests that<br />

such a risk should have been evident to Dr. Hochberg;<br />

thus the risk was foreseeable and the duty to warn<br />

should have attached to Dr. Hochberg.<br />

Furthermore, there is no reporting statute in<br />

<strong>Mass</strong>achusetts requiring physicians to notify the<br />

<strong>Mass</strong>achusetts Registry of Motor Vehicles ("RMV") when<br />

they are treating patients with seizure disorders.<br />

This makes the recognition of a common law duty to<br />

warn patients even more necessary on the grounds of<br />

public safety. While there is no statute requiring a<br />

physician to report his patient to the RMV, the RMV<br />

does require a physician's authorization that his<br />

patient can drive once the patient's license has been<br />

revoked for s zures. 540 CMR § 24.05. Therefore,<br />

the proposed duty is clearly in line with the public<br />

25


judgment as a matter of law. Cassesso v. Comm'r of<br />

Corr., 390 <strong>Mass</strong>. 419, 422 (1983). The moving party has<br />

the burden of establishing that no material facts are<br />

in dispute. Pederson v. Time, Inc., 404 <strong>Mass</strong>. 14, 16­<br />

17 (1989). Dr. Hochberg has not met this burden; on<br />

the contrary, the evidence tends to raise dispute as<br />

to the facts of this case.<br />

Other jurisdictions faced with situations similar<br />

to the present case have routinely held that the<br />

determination of a foreseeable danger to third parties<br />

is a question for the jury; such questions of fact<br />

preclude summary judgment for the physician. This is<br />

especially true when the plaintiff presents evidence<br />

that a physician's act or omission fell below an<br />

accepted standard of care. For example, In Duvall v.<br />

Goldin, 139 Mich.App. 342 (1985), the plaintiff<br />

alleged that the defendant physician failed to inform<br />

his epileptic patient not to operate a motor vehicle.<br />

The Michigan Court of Appeals concluded it was<br />

"foreseeable that a doctor's failure to diagnose or<br />

properly treat an epileptic condition may create a<br />

risk of harm to a third party." rd. at 352. Summary<br />

judgment for the physician was improper because "the<br />

likelihood of injury to a third party due to an<br />

29


also Harden v. Allstate Ins. Co., 883 F.Supp.963<br />

(D.Del.1995). In Freese v. Lemmon l , the Supreme Court<br />

of Iowa held the plaintiffs' petitions, seeking<br />

damages for injuries arising out of a vehicular<br />

accident, stated a cognizable cause of action against<br />

a physician who allegedly failed to advise a patient<br />

not to drive an automobi due to shaving<br />

previously suffered a seizure. 210 N.W.2d 576 (Iowa<br />

1973). In a later appeal, the court held the physician<br />

was not liable on the grounds of the absence of expert<br />

medical testimony establishing the standard of care.<br />

Here, <strong>Medina</strong>'s claim against Dr. Hochberg should<br />

not have been dismissed at summary judgment because<br />

there is evidence that Dr. Hochberg's conduct fell<br />

below the standard of care of a neurologist. Just as<br />

the cited jurisdictions have held, it cannot be said<br />

that the risk of harm to the patient or to <strong>Medina</strong> was<br />

unforeseeable. On the contrary, because Dr. Hochberg<br />

acknowledged in writing that his pati was driving<br />

s than one month prior to the accident, it is<br />

evident that the risk of harm from a motor vehicle<br />

accident was foreseeable. The plainti here did not<br />

1 Subsequently overruled by Schmidt v. Mahoney, 659"<br />

N.W.2d (2003, Iowa).<br />

31


commit the same error as the plaintiff in Freese who<br />

presented no evidence as to the physician's standard<br />

of care. Here, <strong>Medina</strong> presented expert testimony that<br />

establishes the standard of care a neurologist. The<br />

expe testimony further establi that Dr.<br />

Hochberg's failure to warn his ient fell below this<br />

standard. See App: A-54. There , dismissal at<br />

summary judgment was improper and <strong>Medina</strong> should be<br />

allowed to proceed with his action against Dr.<br />

Hochberg.<br />

CONCLUSION<br />

For the foregoing reasons, judgment of the<br />

Superior court should be vacated the Defendant,<br />

Dr. Hochberg's, motion for summary judgment should be<br />

denied.<br />

Respectfully submitted,<br />

Dante G. Mummolo, BBO# 360980<br />

Brendan C. Murphy, BBO# 681672<br />

Iannella & Mummolo<br />

55 Court , Ste. 510<br />

Boston, MA 02108<br />

(617) 227-1538<br />

DATED: AEril 20, 2012<br />

32

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